Suzuki Yugo, Ito Shinji, Ishii Tsuyoshi, Oda Minoru, Hoteya Shu
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Department of Pathology, Toranomon Hospital, Tokyo, Japan.
Case Rep Gastroenterol. 2025 Feb 25;19(1):113-119. doi: 10.1159/000543878. eCollection 2025 Jan-Dec.
Endoscopic submucosal dissection (ESD) is an effective treatment for superficial pharyngeal cancer. However, pharyngeal deformity caused by postoperative ulcer contraction is a major concern and can result in a poor quality of life. While local steroid injections have been shown to prevent strictures after ESD for esophageal cancer, their effectiveness in preventing deformities following ESD for pharyngeal cancer remains unclear.
A 60-year-old woman with superficial pharyngeal cancer in the left pyriform sinus underwent ESD. After ESD, 80 mg of triamcinolone acetonide was injected into the ulcer bed to prevent scar contracture. The patient experienced mild pharyngeal pain, which resolved within a few days. Histopathological examination confirmed the lesion was well-differentiated SCC, with negative resection margins and no lymphovascular invasion. Follow-up endoscopy at 6 weeks showed granulation tissue in the surgical wound, which completely healed without pharyngeal deformity by 14 weeks post-ESD.
This case demonstrated that the injection of triamcinolone in an ulcer that developed after ESD may be an effective method of preventing pharyngeal deformity caused by scar contracture.
内镜黏膜下剥离术（ESD）是治疗浅表性咽喉癌的一种有效方法。然而，术后溃疡收缩引起的咽部畸形是一个主要问题，可能导致生活质量下降。虽然局部注射类固醇已被证明可预防食管癌ESD术后的狭窄，但其在预防咽喉癌ESD术后畸形方面的有效性仍不明确。
一名60岁女性，左侧梨状窝浅表性咽喉癌，接受了ESD治疗。ESD术后，向溃疡床注射80mg曲安奈德以预防瘢痕挛缩。患者经历了轻度咽痛，数天内缓解。组织病理学检查证实病变为高分化鳞状细胞癌，切缘阴性，无脉管浸润。术后6周的随访内镜检查显示手术创面有肉芽组织，ESD术后14周完全愈合，无咽部畸形。
该病例表明，ESD术后溃疡内注射曲安奈德可能是预防瘢痕挛缩引起的咽部畸形的有效方法。
